白内障超声乳化联合人工晶体植入术后干眼症的特点及危险因素分析

Characteristics and risk factors of dry eye after phacoemulsification combined with intraocular lens implantation

目的分析白内障超声乳化(Phaco)及人工晶体植入(IOL)术后干眼症的特点及危险因素。方法选取2020年1月至2022年5月在榆林市第二医院眼科进行白内障Phaco联合IOL术的90例患者作为研究对象。在患者术后3个月回院复查时,对患者的泪河高度、泪膜破裂时间(BUT)、泪液分泌试验值(ST-1)及眼表疾病指数评分(OSDI)进行分析,评估患者术后干眼症情况,并对患者术后发生干眼症的相关因素进行单因素分析及多因素Logistic回归分析。结果90例患者Phaco联合IOL术后3个月复诊检查中发现,55例发生干眼症(干眼症组),35例术后眼睛恢复正常(恢复正常组);干眼症组患者的泪河高度、BUT、ST-1水平分别为(0.15±0.03)mm、(3.89±0.81)s、(6.23±0.99)mm,明显低于恢复正常组的(0.19±0.04)mm、(11.94±2.36)s、(9.56±1.33)mm,OSDI的评分为(35.62±5.69)分,明显高于恢复正常组的(29.86±5.84)分,差异均有统计学意义(P<0.05);经单因素分析结果显示,睑板腺分泌评分、睑脂黏度分级、结膜松弛分级与白内障患者Phaco联合IOL术后发生干眼症状相关(P<0.05),而年龄、性别、高血压、糖尿病与白内障患者Phaco联合IOL术后发生干眼症状无关(P>0.05);经Logistic回归多因素分析结果显示,睑板腺分泌评分、睑脂黏度分级、结膜松弛分级均是白内障患者Phaco联合IOL术后发生干眼症状的主要危险因素(P<0.05)。结论睑板腺分泌评分、睑脂黏度分级、结膜松弛分级是白内障Phaco联合IOL术后干眼症的危险因素,对上述因素进行调控治疗有助于预防患者术后出现干眼症。

Objective To analyze the characteristics and risk factors of dry eye after phacoemulsification(Phaco)and intraocular lens(IOL)implantation.Methods Ninety patients who underwent cataract Phaco combined with IOL surgery in the Department of Ophthalmology,Yulin Second Hospital from January 2020 to May 2022 were selected as the study subjects.When the patient returns to the hospital for follow-up three months after surgery,the tear height,tear film rupture time(BUT),tear secretion test value(ST-1),and ocular surface disease index score(OSDI)of the patient were analyzed to evaluate their postoperative dry eye condition.Univariate analysis and multivariate logistic regression analysis were performed on the relevant factors for the occurrence of dry eye after surgery.Results During the 3-month follow-up examination of 90 patients undergoing Phaco combined with IOL surgery,55 developed dry eye syndrome(dry eye syndrome group),and 35 recovered their eyes to normal after surgery(normal recovery group).The tear river height,BUT,and ST-1 levels in the dry eye syndrome group were(0.15±0.03)mm,(3.89±0.81)s,and(6.23±0.99)mm,respectively,significantly lower than(0.19±0.04)mm,(11.94±2.36)s,and(9.56±1.33)mm in the normal recovery group.The OSDI score was(35.62±5.69)points,significantly higher than(29.86±5.84)points in the normal recovery group(P<0.05).The results of single factor analysis showed that the secretion score of meibomian gland,the viscosity grade of eyelid fat,and the relaxation grade of conjunctiva were associated with dry eye symptoms after Phaco combined with IOL in cataract patients(P<0.05),while age,sex,hypertension,and diabetes were not associated with dry eye symptoms after Phaco combined with IOL in cataract patients(P>0.05).The results of logistic regression analysis showed that meibomian gland secretion score,eyelid fat viscosity grade,and conjunctival relaxation grade were the main risk factors for dry eye symptoms in cataract patients after Phaco combined with IOL surgery(P<0.05).Conclusion Meibomian gland secretion score,eyelid fat viscosity grade,and conjunctival relaxation grade are risk factors for dry eye after Phaco combined with IOL surgery.Regulating and treating these factors can play a positive role in preventing patients from developing dry eye after surgery.